Avoidance behaviour performed in the context of a novel, ambiguous movement increases threat and pain-related fear.
Avoidance behaviour performed in the context of a novel, ambiguous movement increases threat and pain-related fear.
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在新颖、模糊的运动背景下进行的回避行为会增加威胁和与疼痛相关的恐惧。
DOI：
10.1097/j.pain.0000000000002079
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发表时间：
2020
期刊：
影响因子：
7.4
通讯作者：
J. Vlaeyen
中科院分区：
文献类型：
--
作者：
Christine M van Vliet;A. Meulders;L. Vancleef;J. Vlaeyen
慢性疼痛的恐惧回避模型预测，对疼痛的灾难性（错误）解释会激发疼痛相关的恐惧，进而可能刺激回避行为，导致慢性疼痛残疾。在这里，我们研究了是否执行一个动作，以避免一个痛苦的刺激，在一个新的运动的背景下增加威胁和疼痛相关的恐惧对这个新的运动，以及是否回避行为持续进行选择时，获得的运动，以避免一个痛苦的刺激或替代，新的运动。应用机器人手臂到达任务，参与者可以在两种运动之间进行选择以到达目标位置：短但痛苦的运动轨迹，或较长的非痛苦运动轨迹。在避免采集后，删除了选择痛苦轨迹的选项。实验组（N=50）可以在最长轨迹或新颖的中间轨迹之间进行选择，而控制组（N=50）仅允许执行新颖的轨迹。在最后的测试中，两组参与者都可以选择三种轨迹中的任何一种。与对照组相比，实验组参与者对新轨迹的疼痛预期和疼痛相关恐惧增加。在测试过程中，实验组的参与者坚持执行最长的无痛（回避）轨迹，并不太可能选择新的轨迹。此外，与对照组相比，这些参与者对新轨迹保持更高水平的疼痛相关恐惧。这些研究结果表明，在其他中性活动/运动的背景下，避免可能会导致发展和维护的威胁评估和非理性的恐惧。
The fear-avoidance model of chronic pain predicts that catastrophic (mis)interpretation of pain elicits pain-related fear that in turn may spur avoidance behaviour leading to chronic pain disability. Here we investigated whether performing a movement to avoid a painful stimulus in the context of a novel movement increases threat and pain-related fear towards this novel movement, and whether avoidance behaviour persisted when given the choice between performing the acquired movement to avoid a painful stimulus or an alternative, novel movement. Applying a robotic arm-reaching task, participants could choose between two movements to reach a target location: a short, but painful movement trajectory, or a longer non-painful movement trajectory. After avoidance acquisition, the option to choose the painful trajectory was removed. The Experimental Group (N=50) could choose between the longest trajectory or a novel intermediate trajectory, whereas the Control Group (N=50) was allowed to only perform the novel trajectory. In a final test, participants of both groups were allowed to choose any of the three trajectories. Post-acquisition, Experimental Group participants showed elevated pain-expectancy and pain-related fear towards the novel trajectory, compared to the Control Group. During test, the Experimental Group participants persisted in performing the longest pain-free (avoidance) trajectory, and were less likely to choose the novel trajectory. In addition, these participants maintained higher levels of pain-related fear for the novel trajectory compared to the Control Group. These findings suggest that avoidance in the context of other neutral activities/movements may lead to the development and maintenance of threat appraisals and irrational fears.